Study urges tailored use of MHT

New research has highlighted the need for an individualised approach to menopause hormone therapy (MHT), as well as an urgent need for more research into how menopause impacts women of all backgrounds.
 
The study, which included Australian researchers, recognised the treatment’s value, saying it provides menopause symptom relief and skeletal benefits for many midlife women.
 
However, it emphasised the need for shared decision-making between healthcare professionals and patients as ‘systemic MHT is the first line and most effective treatment for menopause symptoms’.
 
‘Current consensus recommendations for MHT emphasise the importance of tailoring type, route, dose, and duration of therapy to individual needs and risk/benefit ratio through shared decision-making,’ the research found.
 
‘MHT may be used as long as benefits outweigh risks, through shared decision-making.
 
‘There is insufficient clinical evidence to support the long-term use of MHT in some contemporary cohorts of women accessing MHT in clinical practice.’
 
It comes at a time of increased, and long-awaited, spotlight on women’s health, including menopause and MHT.
 
This week, the Federal Government announced that three new MHTs will be listed on the Pharmaceutical Benefits Scheme from 1 March – estradiol (sold as Estrogel), progesterone (sold as Prometrium), and estradiol and progesterone (sold as Estrogel Pro).
 
And last year, the RACGP told the Federal Parliament there is a need for improved support and access to care for people experiencing menopause and perimenopause.
 
‘Upskilling of clinicians providing care for patients at midlife, concerning the indications for and prescribing of MHT, urgently needs to be addressed,’ the college’s submission said.
 
But the new study’s researchers said there is still a significant lack of information about the therapy’s effect on women of different backgrounds, saying there are ‘uncertainties or absent data’.
 
‘The majority of published MHT research includes a predominance of white, socially advantaged women with overall low rates of underlying disease,’ the study found.
 
‘Extrapolating data from historical research trials to fundamentally different demographics may not be accurate, and some evidence suggests that selective interpretation of research data is facilitating misinformation about menopause outcomes with MHT.
 
‘Women from minority ethnic and socioeconomically disadvantaged backgrounds may have differing risk profiles, but data are lacking due to their underrepresentation in MHT research.’
 
They said that where data is lacking, the collection of real-world evidence is crucially needed to identify and address these health inequalities.
 
‘There is an urgent need for collections of real-world evidence to track the quality of life and health outcomes in women treated with MHT outside clinical trials,’ the authors said.
 
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menopause hormone therapy MHT perimenopause women’s health